Provider Demographics
NPI:1285365585
Name:PEDIATRIC THERAPY SPECIALISTS, INC.
Entity type:Organization
Organization Name:PEDIATRIC THERAPY SPECIALISTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/CFO/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARMAYNE
Authorized Official - Middle Name:GAYLE
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DSC, PCS
Authorized Official - Phone:626-612-3850
Mailing Address - Street 1:20 E FOOTHILL BLVD STE 220
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-2335
Mailing Address - Country:US
Mailing Address - Phone:626-612-3850
Mailing Address - Fax:
Practice Address - Street 1:20 E FOOTHILL BLVD STE 220
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-2335
Practice Address - Country:US
Practice Address - Phone:626-612-3850
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-19
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty